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STATE OF FLORIDA
~ DEPARTMEI~IT OF REVENUE
~,,d""'n'~ fiSTATE TAX BUREAU
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~ ~ . TALLAHASSEE. FLORIDA 32304
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HARRY L. COE, JR. NONTAXABLE CERTIFICATE AND RECEIPT
EXECYTIYE 0lRECTO~
FOR ESTATE TAX
TO: Robert N. Busenbark, Spouse E A~~~~
C/0 Fee, Koblegard F, Teel, P.A.
P. 0. Box 1000
Ft. Pierce, FL 33450 Re• The Eetate of
' Marie bi. Busenbark
Deceaeed.
~ Residerit of Henry
' ~~~~y~ I 11 ino i s
Date: 6/12/79
=5.00 Fee Heceived:
~ THIS IS TO CEBTIFY, Thst in sccordance ~rith the provisione of Chapter 198,
t Florida Statutes, there hse been filed rvith this °office a s~?orn report or return for Estate
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, Taxea as required by law and on the bsais thereof it has been ascertained the above egtate
f is not aubject to the Florids Estate Tax . The isauance of this certificate, how?ever, shall
not preclude the a~aessment and collection of Estate Taxes subsequently determined to be
due the State of Ftorids. -
If proof of non liability by the above eatate for the Florida Estate Tax is required
by eny pereon thie Certificate may be exhibited ae evidence of such non liability.
Given in quadruplicate under my hand and the seal of the State of Florida the
date fitet sbove ~vritten.
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: Execut~ve rector
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Not •alid without seal affixed . ~ , ~t .ll Q~ .
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~9oK 3i2 P~GE 189
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